Provider Demographics
NPI:1689973935
Name:CYMBAL, DARIA (PT)
Entity Type:Individual
Prefix:MRS
First Name:DARIA
Middle Name:
Last Name:CYMBAL
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MISS
Other - First Name:DARIA
Other - Middle Name:
Other - Last Name:JADLICKYJ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA PT
Mailing Address - Street 1:279 MAIN ST
Mailing Address - Street 2:SUITE 203
Mailing Address - City:NEW PALTZ
Mailing Address - State:NY
Mailing Address - Zip Code:12561-1623
Mailing Address - Country:US
Mailing Address - Phone:845-256-0253
Mailing Address - Fax:845-256-0490
Practice Address - Street 1:279 MAIN ST
Practice Address - Street 2:SUITE 203
Practice Address - City:NEW PALTZ
Practice Address - State:NY
Practice Address - Zip Code:12561-1623
Practice Address - Country:US
Practice Address - Phone:845-256-0253
Practice Address - Fax:845-256-0490
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-24
Last Update Date:2011-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014773282NR1301X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NR1301XHospitalsGeneral Acute Care HospitalRural
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY141340054Medicare UPIN